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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by linkadge on June 25, 2005, at 19:11:24
I've never really had a decent explaination of this concept. If depressed people really had an altered reputake mechanism for serotonin, then why don't "normal" people have sexual side effects, insomnia, and dystonia.
Linkadge
Posted by linkadge on June 25, 2005, at 19:17:02
In reply to But wait ? How does this make sence?, posted by linkadge on June 25, 2005, at 19:11:24
I know its been brought up before, but I feel I am not getting anywhere in my understanding.
Personally, I am more interested in the theory, than in anything else..
This was taken from
http://www.psycheducation.org/mechanism/4WhyShortsLongs.htm
The "long version" of the serotonin transporter gene is longer because of these. Somehow this tandem repeat also makes the gene produce more protein product, which goes to work on grabbing serotonin from the synapse. The result: cells with "two longs" take up twice as much serotonin from they synapse as cells with a short or two shorts.Lesch
--------------------------------------------Why then, do SSRI's which serve to slow the reputake system futher, have any efficacy in with this so called bad serotonin allele.
Linkadge
Posted by Jen Star on June 25, 2005, at 19:17:04
In reply to But wait ? How does this make sence?, posted by linkadge on June 25, 2005, at 19:11:24
my doctor said something about "if the Lexapro settles into your brainstem, you'll have sexual side effects and can't get rid of them." From that, I take it to mean that the drugs DO help serotonin get reuptaken properly, BUT They also go other places and may block other functions, too...
what are your thought?
JenStar
Posted by linkadge on June 25, 2005, at 19:36:44
In reply to Re: But wait ? How does this make sence? » linkadge, posted by Jen Star on June 25, 2005, at 19:17:04
MY understanding was that the reason the drugs to cause sexual side effects (and apathy for that matter) is because they generally lower dopamine in certain limbic regions, and the brain stem.
I think too, that it is due to too much activation of the 5-ht2c receptor. This is why drugs like periactin, and mirtazapine block the sexual side effects.
But I don't think it is the molecule itself (since all strong serotogenics cause sexual side effects), but rather the effect of blocked reputkate.
I don't know what to make of it
Linkadge
Posted by SLS on June 25, 2005, at 21:30:33
In reply to But wait ? How does this make sence?, posted by linkadge on June 25, 2005, at 19:11:24
> I've never really had a decent explaination of this concept. If depressed people really had an altered reputake mechanism for serotonin, then why don't "normal" people have sexual side effects, insomnia, and dystonia.
Thinking out loud...
The dynamics of the system include many feedback loops that help keep it running at a nominal velocity. Perhaps people with the each version of the 5-HT transporter display a different complementary rate of second messenger events and the expression of varying numbers of membrane receptors. For example, there is a *higher* number of 5-HT2a post-synaptic receptors found post-mortem in suicide victims. Yet, 5-HT1a autoreceptors are upregulated as well. It is counterintuitive to think that a reduced rate of reuptake would produce such a state, except that the upregulated autoreceptors work to reduce the rate of synthesis and release of serotonin. This would help to balance a sluggish reuptake system. It seems to me, however, that such a system would not tolerate perturbations very well. There isn't much room left for homeostatic mechanisms to compensate for stress and overactivity. On the other hand, a greater number of transporters allows for greater variation in the sensitivities of receptors to maintain homeostasis during stressful times because they are not upregulated to begin with.
- Scott
Posted by 4WD on June 25, 2005, at 21:50:07
In reply to But wait ? How does this make sence?, posted by linkadge on June 25, 2005, at 19:11:24
> I've never really had a decent explaination of this concept. If depressed people really had an altered reputake mechanism for serotonin, then why don't "normal" people have sexual side effects, insomnia, and dystonia.
>
>
>
> Linkadge
LInkadge,It is my understanding that it is not the decrease in reuptake directly that is responsible for the AD effect. I have read that the decreased reuptake causes adaptive changes in the brain somewhere further along the line and that it is these changes which result in a response to the med. Just my two cents worth...
Marsha
Posted by linkadge on June 25, 2005, at 21:53:17
In reply to Re: But wait ? How does this make sence?, posted by SLS on June 25, 2005, at 21:30:33
Whoa, you just flew right over my head.
Ok, so lets say that we have these receptor abnormalities. If all effective antidepressants regulate this, then it would it stand to reason that tianeptine might do the same. If so, then 2a downregulation does not happen as a result of increased or decreased reputake.
Linkadge
Posted by linkadge on June 25, 2005, at 22:05:12
In reply to Re: But wait ? How does this make sence?, posted by linkadge on June 25, 2005, at 21:53:17
Posted by SLS on June 25, 2005, at 22:36:52
In reply to Above was in response to SLS (nm), posted by linkadge on June 25, 2005, at 22:05:12
Time for bed.
Good night, Linkadge.
I hope you never lose your desire to survive. It is an obvious one. You will win. You already do win every time you wake up in the morning and refuse to let your condition beat you. Today, you are one day closer to achieving your goal; one day closer to reaching the promised land. Your brain is not areactive to medication. It will remain plastic and retain the potential to be re-regulated and attain remission. The degree to which you would profit from psychotherapy is uncertain. You won't know until you add it to your treatment regime. If nothing else, it would give you tools to cope with those things that are otherwise beyond your control. At best, it will provide you with the recognition and insight into what issues you might be struggling with and provide a basis for learning how to change your thoughts and behaviors.
I don't know how I got off on that tangent.
I'll sleep on what we were talking about. Your comments and questions make sense. I'm not sure my model does, though. Have you ever pictured a dynamic system in your mind but found it difficult to put into words?
- Scott
Posted by linkadge on June 25, 2005, at 22:56:49
In reply to Re: I think I burned by brain out on that one. » linkadge, posted by SLS on June 25, 2005, at 22:36:52
I am working on attending counselling. Again, a small waiting list.
Linkadge
Posted by SLS on June 26, 2005, at 7:36:44
In reply to Re: I think I burned by brain out on that one., posted by linkadge on June 25, 2005, at 22:56:49
> I am working on attending counselling. Again, a small waiting list.
I am sure I speak for all in saying that we wish you nothing but success in all phases of your treatment. There is just too much Linkadge to allow to go to waste.
drugs < drugs + counselling
A good doctor of mine indicated to me years ago that even were he to find an adequate drug therapy, my perfectionism and other psychological issues might be significant enough to cause medication-breakthrough and relapse. I've been working on these issues ever since. I'm not completely there, but much has been resolved. What's left, I am now seeing a counsellor to work on. I believe that my level of residual psychosocial maladjustment is too small to antagonize the workings of medication. It is one less set of stressors that might otherwise cause a relapse once remission is achieved.
- Scott
Posted by Jazzed on June 26, 2005, at 11:58:59
In reply to Re: But wait ? How does this make sence?, posted by SLS on June 25, 2005, at 21:30:33
> The dynamics of the system include many feedback loops that help keep it running at a nominal velocity. Perhaps people with the each version of the 5-HT transporter display a different complementary rate of second messenger events and the expression of varying numbers of membrane receptors. For example, there is a *higher* number of 5-HT2a post-synaptic receptors found post-mortem in suicide victims. Yet, 5-HT1a autoreceptors are upregulated as well. It is counterintuitive to think that a reduced rate of reuptake would produce such a state, except that the upregulated autoreceptors work to reduce the rate of synthesis and release of serotonin. This would help to balance a sluggish reuptake system. It seems to me, however, that such a system would not tolerate perturbations very well. There isn't much room left for homeostatic mechanisms to compensate for stress and overactivity. On the other hand, a greater number of transporters allows for greater variation in the sensitivities of receptors to maintain homeostasis during stressful times because they are not upregulated to begin with.
>
>
> - Scott
Scott,What DO you DO for a living? Your posts are always so intelligent. Sometimes they go SO over my head, but I always find them interesting, so I try to hang in there and "get it". I would love to be intelligent. I find others posts to be that way too, like linkadge and larry, and lots of others. I missed the gene pool on this one.
Jazzy
Posted by Jazzed on June 26, 2005, at 12:01:27
In reply to Re: I think I burned by brain out on that one. » linkadge, posted by SLS on June 25, 2005, at 22:36:52
> I don't know how I got off on that tangent.
>
> I'll sleep on what we were talking about. Your comments and questions make sense. I'm not sure my model does, though. Have you ever pictured a dynamic system in your mind but found it difficult to put into words?
>
>
> - ScottAnd you're nice too, I think I'm in love. Oh yeah.....I'm married. JK
Jazzy
Posted by SLS on June 26, 2005, at 19:37:50
In reply to Re: But wait ? How does this make sence? » SLS, posted by Jazzed on June 26, 2005, at 11:58:59
Hi Jazzy.
Thanks for the stroking. I needed that today.
> What DO you DO for a living?
Nothing at the moment. I am a college dropout (due to depression) who once worked as a fitness instructor and car salesman.
> Your posts are always so intelligent.
I just use big words. Don't let them fool you. :-)
> I would love to be intelligent.
One of the things that I have discovered in people is that we are all of roughly the same intelligence. The biggest differences lie in education - whether it be in school or in real life - and the exercising of the mind to sharpen its skills. I guarantee you that I could get you to understand anything that I can. It is just a matter of how smart I am to be able to offer an effective explanation. However, it helps to recognized that each of us has our strengths and weaknesses in different mental skills and aptitudes. Life would be less interesting if we were all basically mental clones.
> I missed the gene pool on this one.
I guess you already know how I feel about statements like that one. You haven't missed anything but the development a framework of education within which to understand the more detailed and complex ideas. I had some education in biology which allowed me to further educate myself using the literature that was available to me. You could do the same thing if you wanted to. It is just a matter of work and time, and perhaps some guidance. The critical question is, would you really want to. Probably not. You might be satisfied with learning only what is necessary to get yourself well. Anything else is esoteric.
I still need to use a dictionary.
- Scott
Posted by Jazzed on June 27, 2005, at 7:53:53
In reply to Re: But wait ? How does this make sence? » Jazzed, posted by SLS on June 26, 2005, at 19:37:50
> Hi Jazzy.
>
> Thanks for the stroking. I needed that today.Aw, Scott, I'll give you strokes anytime, you're always so nice to ppl. Sorry you're having a bad day. Anything you want to talk about on the thread?
>
> > What DO you DO for a living?
>
> Nothing at the moment. I am a college dropout (due to depression) who once worked as a fitness instructor and car salesman.ooooo, we're looking for a car, I hate going to car dealerships, generally hate dealing with the salesmen! BLEH! Are you still into fitness? I swim, bike, and walk. Used to run and run steps, but sprained my ankle and I know if I try to run on it, it'll be worse. I can't seem to get it to heal, but I do still walk 3-5 miles every night. I am still overweight though. I think that, as a teen, when I took meds it permanently messed with my metabolism. My GP even acknowledged I have a slow metabolism. Oh well exercise makes me feel better.
>
>
> I just use big words. Don't let them fool you. :-)LOL, okay!
>
>
> One of the things that I have discovered in people is that we are all of roughly the same intelligence. The biggest differences lie in education - whether it be in school or in real life - and the exercising of the mind to sharpen its skills.I want to go back to school, so I hope I can study and learn. My IQ's not bad, just that I don't retain well, and when something I read starts to get complicated, it all jumbles up and I can't get it. It's my ADD, the thoughts just won't stay on the track.
>
> I still need to use a dictionary.
>
; )
Jazzy
Posted by mworkman on June 27, 2005, at 11:28:15
In reply to Re: But wait ? How does this make sence? » SLS, posted by Jazzed on June 27, 2005, at 7:53:53
I think it is because ssri's lower dopamine. That is why drugs like wellbutrin can help with the sex side effects.
Posted by linkadge on June 27, 2005, at 16:37:47
In reply to Re: But wait ? How does this make sence?, posted by mworkman on June 27, 2005, at 11:28:15
I think you're right.
Linkadge
This is the end of the thread.
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